Since the late 1980s, interest has grown in the development of health education in schools. This interest has been spurred on by the AIDS pandemic. Health education, which focuses on trying to influence sexual behaviour and attitudes, has been seen as a key strategy in arresting the spread of the disease. To what extent, however, is health education (including HIV/AIDS prevention education) currently included in the curriculum of schools in Africa and Asia? And what is its relevance to children's needs, teaching methods and teacher preparation? Researchers at the Liverpool School of Tropical Medicine report on a study that sets out to answer these questions and to suggest ways of improving health and HIV/AIDS education in schools.

The study had two main elements:

• a review of available literature and documentary evidence on the current state of health and HIV/AIDS education in primary and secondary schools in Africa and Asia
• case studies of policy and practice in such education in Ghana, India, Pakistan, and Uganda. The case studies include an assessment of schoolchildren's perceptions on health and HIV/aids using the 'draw and write' method

Research findings indicate that health education is included in curricula in all these cases, but that it is generally very limited. There are examples of both 'separate subject' and 'integrated' health education. The latter appears to be more successful in ensuring that children receive some teaching in this area. Teaching methods in all countries predominantly focus on didactic approaches, but there are some examples of more participatory approaches, especially in Uganda. Uganda is also notable as being the only country to have formal teacher preparation specifically on health education.

Schools in Africa and Asia often lack basic hygiene and drinking water facilities. They provide little or no adequate food, lighting and ventilation are poor and other shortcomings abound. School health services are equally rudimentary, often entirely lacking. A growing number of countries, however, are experimenting with more targeted health interventions (such as de-worming or micronutrient supplementation) though the schools system.

There have been few attempts to use health needs assessments of school aged children as a basis for health education planning (although Ghana has made some useful advances in this area). Likewise, there is even less evidence of research into the concerns of young people with a view to curriculum planning.

There are very few examples of ongoing monitoring or evaluation related to school health education programmes. Rather more is available on evaluating mass media campaigns for HIV/AIDS awareness. Evaluation of health education in schools demonstrates that it can substantially improve knowledge of health topics. Evidence of a link between health education and behavior is more limited and underlines the importance of supporting education with health services, and of paying attention to the broader 'health environment' of the school. Key factors influencing the impact of health education include:

• links with health services
• teacher preparation
• time devoted to health education
• parent participation
• the timing of health education input (in terms of pupil age)
• the presence of operational school policies which support health promoting behaviours.

Source(s):
Health & HIV/AIDS education in primary and scecondary schools in Africa and Asia, DFID Education Research Paper No. 14, E. Barnett et al (1995)

Funded by: DFID Education Division, UK (1993-1995)

id21 Research Highlight: 1998-May-14

Further Information:
E. Barnett, K. de Koning or V. Francis
Liverpool School of Tropical Medicine
Pembroke Place
Liverpool
L3 5QA
UK

Tel: +44 (0) 151 7089393
Fax: +44 (0) 7071702
Contact the contributor: dekoning@liverpool.ac.uk

Liverpool School of Tropical Medicine (LSTM), UK

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